FREQUENCY OF SECONDARY LACTOSE INTOLERANCE IN CHILDREN WITH SEVERE ACUTE MALNUTRITION WITH DIARRHOEA
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Abstract
Objective: To determine the frequency of lactose intolerance in children with severe acute malnutrition presenting with
diarrhea.
Material and method: This study was conducted in nutritional rehabilitation unit, Khyber teaching hospital Peshawar
from June 2014 to December 2014. It was a descriptive cross sectional study comprising of 150 paediatric patientsranging
from 5 months to 5 years of age who met the WHO criteria of acute severe malnutrition having Z-score of <-3SD
with weight for height/length, age and sex presenting with diarrhea. Then stool was tested for reducing substances in
freshly collected sample.
Results: Of the total 150 patients of 5-60 months of age (mean age 17.7±11.91 SD), 82(54.7%) were male and 68(45.3%)
were female. Overall 41(27.3%) were lactose intolerant (having diarrhea with positive stool reducing substances)
among them 21 were male (51.2%) while 20 were female (48.7%), 32 patients (78.04%) were having kwashiorkor and
9 patients (21.9%) were marasmic. Perianal rash, abdominal distention were present in 37 (90.2%) and, 38 (92.6 %)
patients respectively. The findings which were significantly observed in children with lactose intolerance were edematous
malnutrition (p-value 0.003), perianal rash (p-value 0.00), and abdominal distention (p-value 0.00).
Conclusion: Secondary lactose intolerance is a common problem of children with acute severe malnutrition presenting
with diarrhea. Clinical signs of lactose intolerance in severely malnourished children are perianalexcoriation of skin
and abdominal distention.
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